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About:
Hypocapnia after traumatic brain injury: how does it affect the time constant of the cerebral circulation?
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research paper
schema:ScholarlyArticle
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Academic Article
research paper
schema:ScholarlyArticle
isDefinedBy
Covid-on-the-Web dataset
has title
Hypocapnia after traumatic brain injury: how does it affect the time constant of the cerebral circulation?
Creator
Czosnyka, Marek
Smielewski, Peter
Ch, Bernardo
Despina, ·
Kasprowicz, Magdalena
Lalou, Afrodite
Lalou, Despina
Luzius, ·
Puppo, Corina
Smielewski, ·
Steiner, A
Steiner, Luzius
Steiner@usb, Luzius
Yelicich,
Yelicich, Bernardo
Source
PMC
abstract
The time constant of the cerebral arterial bed (“tau”) estimates how fast the blood entering the brain fills the arterial vascular sector. Analogous to an electrical resistor–capacitor circuit, it is expressed as the product of arterial compliance (Ca) and cerebrovascular resistance (CVR). Hypocapnia increases the time constant in healthy volunteers and decreases arterial compliance in head trauma. How the combination of hyocapnia and trauma affects this parameter has yet to be studied. We hypothesized that in TBI patients the intense vasoconstrictive action of hypocapnia would dominate over the decrease in compliance seen after hyperventilation. The predominant vasoconstrictive response would maintain an incoming blood volume in the arterial circulation, thereby lengthening tau. We retrospectively analyzed recordings of intracranial pressure (ICP), arterial blood pressure (ABP), and blood flow velocity (FV) obtained from a cohort of 27 severe TBI patients [(39/30 years (median/IQR), 5 women; admission GCS 6/5 (median/IQR)] studied during a standard clinical CO(2) reactivity test. The reactivity test was performed by means of a 50-min increase in ventilation (20% increase in respiratory minute volume). CVR and Ca were estimated from these recordings, and their product calculated to find the time constant. CVR significantly increased [median CVR pre-hypocapnia/during hypocapnia: 1.05/1.35 mmHg/(cm(3)/s)]. Ca decreased (median Ca pre-hypocapnia/during hypocapnia: 0.130/0.124 arbitrary units) to statistical significance (p = 0.005). The product of these two parameters resulted in a significant prolongation of the time constant (median tau pre-hypocapnia/during hypocapnia: 0.136 s/0.152 s, p ˂ .001). Overall, the increase in CVR dominated over the decrease in compliance, hence tau was longer. We demonstrate a significant increase in the time constant of the cerebral circulation during hypocapnia after severe TBI, and attribute this to an increase in cerebrovascular resistance which outweighs the decrease in cerebral arterial bed compliance.
has issue date
2019-06-07
(
xsd:dateTime
)
bibo:doi
10.1007/s10877-019-00331-x
bibo:pmid
31175502
has license
no-cc
sha1sum (hex)
27c8d9fccef4d85b13f6761171fcbfc8b1016e79
schema:url
https://doi.org/10.1007/s10877-019-00331-x
resource representing a document's title
Hypocapnia after traumatic brain injury: how does it affect the time constant of the cerebral circulation?
has PubMed Central identifier
PMC7223592
has PubMed identifier
31175502
schema:publication
J Clin Monit Comput
resource representing a document's body
covid:27c8d9fccef4d85b13f6761171fcbfc8b1016e79#body_text
is
schema:about
of
named entity 'calculated'
named entity 'cerebral circulation'
named entity 'time constant'
named entity 'respiratory minute volume'
named entity 'IQR'
named entity 'GCS'
named entity 'arbitrary'
named entity 'intracranial pressure'
named entity 'arterial blood pressure'
named entity 'head trauma'
named entity 'flow velocity'
named entity 'ESTIMATED FROM'
named entity 'HYPOCAPNIA'
named entity 'HYPERVENTILATION'
named entity '1.05'
named entity 'CIRCUIT'
named entity 'GCS'
named entity 'PRE'
named entity 'COMBINATION'
named entity 'STATISTICAL SIGNIFICANCE'
named entity 'MIN'
named entity 'FAST'
named entity 'DECREASE'
named entity 'PERFORMED BY'
named entity 'CEREBRAL CIRCULATION'
named entity 'BLOOD FLOW VELOCITY'
named entity '152'
named entity 'SEVERE'
named entity 'REACTIVITY'
named entity 'RESPIRATORY MINUTE VOLUME'
named entity 'TBI'
named entity 'THE BRAIN'
named entity '124'
named entity 'THEIR'
named entity 'CEREBRAL'
named entity 'CEREBROVASCULAR'
named entity 'THESE'
named entity 'DECREASED'
named entity 'arterial'
named entity 'entering'
named entity 'TBI'
named entity 'dominate'
named entity 'trauma'
named entity 'circuit'
named entity 'units'
named entity 'time constant'
named entity 'hyperventilation'
named entity 'TBI'
named entity 'hyperventilation'
named entity 'capillary'
named entity 'hyperventilation'
named entity 'EtCO'
named entity 'blood volume'
named entity 'MCA'
named entity 'Wilcoxon signed-rank test'
named entity 'hyperventilated'
named entity 'ABP'
named entity 'CPP'
named entity 'Fast Fourier transformation'
named entity 'admission'
named entity 'lengthening'
named entity 'ABP'
named entity 'arterial'
named entity 'predominant'
named entity 'intense'
named entity 'vasoconstrictive'
named entity 'severe'
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